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论文编号：	15508
作者编号：	2320224251
上传时间：	2025/6/13 17:40:12
中文题目：	基于作业成本法的DF医院成本核算改进研究
英文题目：	Research on the Improvement of Cost Accounting in DF Hospital Based on Activity-Based Costing
指导老师：	王志红
中文关键字：	疾病诊断相关分组付费模式；作业成本法；病种成本
英文关键字：	DRG payment model;Activity-based costing; Disease cost
中文摘要：	当下社会，公立医院在医疗卫生体制改革中面临越来越严峻的挑战，于近些年提出的疾病诊断相关分组（DRG）付费模式的实施要求医院更加注重成本控制和效率提升。为了应对医保支付政策的不断收紧，国家卫生健康委于2023年12月发布了《公立医院成本核算指导手册》，要求医院开展多维度成本核算，推动成本控制体系的构建。在这一背景下，医院管理急需一种更适用的成本管理方法，而作业成本法则是一种新型的成本核算和管理方法。通过精确计算产品分配的间接成本，作业成本法可以实现对医院成本的精细化管理，有助于更准确地反映经营环节的费用状况，并帮助管理层进行治疗环节的优化。 DF医院临床科室已完成了DRG付费模式的改革，并正处于深化阶段，因此以其为研究对象，对DRG付费模式下运用作业成本法对病种成本进行计算具有相当的代表性，而且能够为其他公立医院提供有益的借鉴和参考。本文首先梳理回顾了国内外作业成本管理的相关文献和研究现状，为优化与设计DRG付费模式下的成本管理方案提供了思路参考和理论支撑。随后，通过对DF医院当前成本核算管理现状的详细调查和分析，发现了其在成本核算和管理上存在的问题，如成本测算难以反映真实成本、缺乏对成本的有效分析与控制等。针对这些问题，本文结合DRG付费模式的要求，设计出DF医院通过作业成本法对特定病种进行成本管理的具体实施步骤，对计算出的现有成本、作业成本、医院收入间进行差异现状分析，证实了作业成本法对于准确核算实际成本、优化医院资源配置、完善医保价格机制的作用。本文基于实际状况，成功探索出利用DRG付费模型，进行特定病种作业成本管理的路径，期望能给其他医疗机构带来相关的借鉴意义。
英文摘要：	With the accelerating pace of healthcare reform in China, the challenges faced by public hospitals in their operation and development have become increasingly prominent. Particularly in recent years, the implementation of the DRG payment model has required hospitals to pay more attention to cost control and efficiency improvement when providing medical services to cope with increasingly strict medical insurance payment policies. In December 2023, the National Health Commission issued the "Guidance Manual for Cost Accounting in Public Hospitals", requiring hospitals to conduct multi-dimensional cost accounting, enhance accounting levels, and actively apply cost accounting results in combination with operational management goals to build a cost control system. Against this backdrop, hospital management needs a new and more applicable cost management method. Activity-based costing is precisely such a method that integrates relatively new cost accounting and management approaches. By accurately calculating the indirect costs allocated to products, it can achieve refined cost management in hospitals, helping to promote more precise cost accounting in public hospitals and accurately reflect the cost situation of each operational link, assisting management in optimizing treatment processes. DF Hospital's clinical departments have completed the reform of the DRG payment model and are currently in the deepening stage. Therefore, taking it as the research object, the application of activity-based costing to calculate the cost of specific diseases under the DRG payment model is highly representative and can provide useful references for other public hospitals. This paper first reviews the relevant literature and research status of activity-based cost management at home and abroad, providing ideas and theoretical support for optimizing and designing cost management plans under the DRG payment model. Subsequently, through a detailed investigation and analysis of the current cost accounting and management situation of DF Hospital, problems in cost accounting and management were identified, such as the difficulty in reflecting the true cost through cost estimation and the lack of effective analysis and control of costs. In response to these issues, this paper, in combination with the requirements of the DRG payment model, designs specific implementation steps for DF Hospital to manage the cost of specific diseases through activity-based costing, and conducts a comparative analysis of the existing cost, activity cost, and cost per billion yuan of revenue, confirming the role of activity-based costing in accurately calculating actual costs, optimizing hospital resource allocation, and improving the medical insurance price mechanism. Based on the actual situation, this paper successfully explores the path of using the DRG payment model for activity-based cost management of specific diseases, hoping to bring relevant reference significance to other medical institutions.
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